A Truthful look at Postpartum - 9 Months In/9 Months Out with baby #9

9 months ago we welcomed our ninth baby, a beautiful baby girl

My body has carried and delivered 9 babies and 1 angel baby in 13 years. I am proud of every stretch mark and excess fold of skin. I had hypermesis gravidarium in 6 out of my 9 pregnancies. I have had countless bags of IV fluids, Zofran pumps, iron infusions and 2 blood transfusions during my pregnancies.

Just like every pregnancy can be different so is the recovery. This postpartum recovery has been my hardest. I had physical postpartum issues that I haven’t had before. Thankfully my midwife suggested pelvic physical therapy which healed all those issues for me (see previous blog post). My youngest 3 kiddos were 2 and under which I think also added to a difficult recovery.

Emotionally it has been hard. Our sweet 9th is our last baby and I hadn’t anticipated how hard all those “lasts” would be. I suffered from postpartum depression for the FIRST time after baby number 9. It took me awhile to figure out what it was. Not having it before, it was not on my radar that I would have it this time. I am on a low dose of medication and feeling much better. Postpartum is beautiful and transformative but is also challenging and messy. The hardest part about postpartum issues (physical and mental health related) is that as moms we have to diagnosis ourselves, acknowledge it and seek help, all while taking care of our kids. One of my challenges was once I figured out I had postpartum depression, I didn't have a primary care doctor to go and see. My OB office had been my "primary care" doctors for the past several years. Thankfully I found a wonderful nurse practitioner who helped me. I wish there were more postpartum resources and care for moms in the U.S.

Being a mom of 9 doesn’t mean I am super human, I make mistakes and learn new parenting things everyday. 

After I healed from my physical postpartum issues I hit the gym. Working out is definitely my sanity. With a husband that travels often, going to the gym may be the only hour I have that week by myself and to shower. The gym I go to has a fantastic child care center. The other change I made was in my eating. I was struggling with low energy and extreme fatigue. I was desperate to try anything that would help. I did Whole30 in March and I could feel a change in my energy level almost immediately. 

Being an only child I am still in awe of this beautiful family we have created. Thank you to my amazing hubby and friends that have helped me through these past 9 months. 

Moms are AMAZING. We need to lift each other up, cheer each other on and support one another. 

Postpartum Pelvic Physical Therapy stopped my insides from falling out after my last baby

My postpartum recovery from diastasis recti, weakened pelvic floor and prolapsed bladder after my last baby using pelvic rehab therapy

I am not a medical professional, this is my personal postpartum recovery journey, please consult your doctor before beginning any type of treatment plan. This is not a paid or sponsored post, I genuinely had a fantastic experience with Dr. Le and Sport and Spine Rehab and physical therapy worked to resolve my postpartum issues. 

My postpartum recovery from baby number 9 has been my hardest to date; mentally, physically and emotionally.

I have had 9 kids in 13 years, my last 5 in 6 years and my last 2 babies were 11 months apart. I recovered quickly after all of my deliveries. Let’s be honest, I have had a good run. I could tell that something wasn’t right after my 9th baby was born in July. I was feeling vaginal/pelvic pressure, like I was still pregnant and felt like I needed to pee ALL THE TIME. I chalked it up to having a lot of kids and figured that it would get better, it didn't. For my birthday in September, my best friend who is a personal trainer, treated me to a training session. I was about 10 weeks postpartum at the time. I had been much slower to work out after this last baby, things just didn’t feel right. While I was working out with my friend, she had me do some body weight squats and I felt like my insides were falling out from pressure. When I did planks she asked me to tighten my core and I literally was trying so hard and couldn’t tighten anything. My abdomen muscles were jello.

I had my post delivery appointment with my midwife, Amanda, that next week. I told her how I was feeling and then after the exam she told me that I had a severely weakened pelvic floor, a prolapsed bladder and level 3 diastasis recti. It made total sense with how I had been feeling, but now what? I had never had any recovery issues in the past. I had heard of all those terms but had to look them up after my appointment. Postpartum diastasis recti is when the abdominal muscles separate during pregnancy. Pregnancy and childbirth can weaken the muscles and connective tissue in the pelvic area. A prolapsed bladder is when the vaginal wall is too weak to hold up the bladder and it droops down into the vagina. I kept asking Amanda, this is going to get better right, RIGHT? She never said yes, just we’ll see. I had a neighbor that had to have surgery on her prolapsed bladder and it was a rough recovery, she couldn’t lift anything for weeks. I have 3 kids 2 years and under, how would that work. My midwife suggested that I try physical therapy first. I got the referral and called right away. Anyone that knows me, knows I am horrible about self care, with 9 kids, my needs are last. But this time I called right away, I was feeling miserable and really wanted to try the physical therapy route to see if I could avoid surgery.

The physical therapy place, Sport and Spine Rehab - Chiropractic and Physical Therapy Clinic, was close by and I was able to get in quickly. I really had no idea what type of exercises I would be doing, I was definitely nervous. First I met with Dr. Tiffanie Le, she was fabulous and outlined that I would be working on strenthing my core muscles in the hopes that by strengthing my pelvic floor, it would pull everything back up again, in particular my bladder. That first session I was a little self conscious, but quickly shed that. For the diastasis recti they taught me how to roll to my side then use my arms to push up versus doing a sit up, which was ugly for me anyway right now. Then they proceeded to take me through a series of core strenthing and breathing exercises. They would have me start with a warm up, like the Bruegger Postural Relief then work on the core exercises.

Pictured below are the foundation exercises and each week the physical therapist would build on them.

Bruggers Postural Relief

Belly Breathing

Pelvic Tilts

    

Dead Bug

Modified Bird Dog

Glute Bridge

With 9 kids and a husband that travels I was only able to make it to therapy 2 x a week. Most of the exercises I was able to do at home, which I tried to do several times a week. Sport and Spine Rehab had great hours including evening hours and they were also very accommodating and let me bring my new baby with me to appointments. Those first few weeks the exercises were really challenging. I am an active person, but the concentration that it took me to tighten my core and squeeze my pelvic floor muscles was intense. I would leave sweating. 5 weeks into physical therapy I started to feel a change. My frequency/urgency to pee was less, the pelvic pressure I was feeling was less. My core muscles were weak but I could feel them start to tighten.

I continued my sessions 1-2 x a week for the next 4 weeks. I was feeling so much better. I had a follow up appointment with my midwife in December. I was really hoping that how I was feeling would translate into a good internal exam. I was holding my breath literally and figuratively during the exam. The physical therapy had worked! My bladder was no longer prolapsed, my pelvic wall was much stronger and my diastsis recti had gone from a 3 finger separation to a 1! Woohoo! I was estatic! If things had not worked out and I was told I would need surgery we would have figured out a way to make it work, but I was so excited to not have to go down that path.

The next day I had an appointment with Dr. Le and her staff, I had graduated from their program. They walked me through some more advanced core exercises that I could do on my own. I truly liked everyone that I had worked with there. They were all kind, proffessional and encouraging. They all gave me hugs as I walked out.

I am continuing to do the core exercises a couple of times a week and will do that for the forseeable future. My core strength is still not where I would like it to be, but I am working on making it stronger every week. My prolapsed bladder issues have been resolved and I can make it through a hard workout without feeling I needed to use the bathroom 10 times.

Here is my takeaway:

• All of these pregnancy/postpartum complications I experienced can happen whether it is your first or ninth baby. My guess is that I had all of these issues after my seventh and eighth babies but since I was pregnant again so quickly they were not caught. 
• I saw plenty of pregnant women at Sport and Spine Rehab strengthing their core. I wish I would have done that. 
• I think that most moms would benefit from pelvic floor/core strengthening even without an official diagnosis.
• I am so grateful that my midwife suggested physical therepy first versus surgery first. 
• I also should have been more timely with my post delivery 6 week check up, by the time I was seen I was 10-11 weeks postpartum. 

Here are some tips that Dr. Le and I talked about for other mommas facing these postpartum issues. 

1. If your OB recommends physical therapy make sure that you look for a Chiropractic/Physical Therapy place that is comfortable and knowledgeable working with postpartum moms. 
2. You will want a program that emphasizes building back up the core muscles through core muscle exercises, breathing training, and postural training. All 3 will work to re-engage the pelvic floor. Make sure that you ask questions about the purpose of the program and exercises that you are put on. You want to make sure they are solving for what you need strengthened. 
3. Do not be discouraged by this diagnosis, it will take time and hard work to heal 
4. Slowing things down in the postpartum period will help you return to your desired level of activity with less risk of injury. During this time your body relearns to engage proper muscles to help you move better when you do return to your sport/activity. 
5. Once you are on a program be compliant and consistent so you can get results.
6. Keep in mind that not every pregnancy and birth is the same and the amount of activity prior to and during the pregnancy affects recovery.
7. All mommas, prenatal and postpartum, can benefit from core training and exercise, you don't need to wait to be diagnosed with a condition or have pain to start rehab and therapy for your core and pelvic floor.

Dr. Le has her Doctor of Chiropractic degree from New York Chiropractic College. She is also:

- Webster certified (a chiropractic technique commonly used with pregnant patients; website for more info can be found here: https://icpa4kids.com/training/webster-certification/webster-technique/ ) 

- attended the Birthfit Professional Seminar (https://birthfit.com/) 

- in the process of acquiring her birth doula certification through DONA International (https://www.dona.org/)